Schick U, Huguet F, Pointreau Y, Pradier O
Service de radiothérapie, institut de cancérologie et d'hématologie, CHRU Morvan, 2, avenue Foch, 29200 Brest, France.
Service d'oncologie radiothérapie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Université Paris 6, 4, rue de la Chine, 75020 Paris, France.
Cancer Radiother. 2017 Oct;21(6-7):498-504. doi: 10.1016/j.canrad.2017.07.032. Epub 2017 Aug 31.
Therapeutic principles of radiation therapy in head and neck carcinomas will be discussed in this review. Intensity-modulated radiotherapy with concomitant cisplatin should be standard. In case of contraindication to chemotherapy, cetuximab is an option, while hyperfractionation should be considered in patients unfit for concomitant treatment. Concomitant chemotherapy should be administered in the presence of extracapsular extensions and positive margins in the postoperative setting. Current research areas such as desescalation in human papillomavirus-positive tumours, adaptive radiotherapy, radiomics and immunotherapy will also be addressed.
本综述将讨论头颈部癌放射治疗的治疗原则。调强放疗联合顺铂应成为标准治疗方案。若存在化疗禁忌证，西妥昔单抗是一种选择，而对于不适合同步治疗的患者应考虑超分割放疗。术后出现包膜外扩展和切缘阳性时应给予同步化疗。当前的研究领域，如人乳头瘤病毒阳性肿瘤的降阶梯治疗、自适应放疗、放射组学和免疫治疗也将予以探讨。
